Are You Underpaid as a Physician?

If you feel underpaid as a physician, it's crucial to take action to optimize your earnings and financial position. This might include negotiating better pay, considering relocation to a higher-paying metro area, or even changing employers or specialties.

You Are Not Alone in Feeling Underpaid

49% of physicians report feeling underpaid.

The first step in better advocating for yourself and negotiating higher compensation is having the most accurate data and information to benchmark yourself. Sign up for Offcall's Salary Tool in order to get a free assessment of where you stand relative to peers in your speciality. We are building the largest and most accurate physician compensation database to give physicians more leverage in negotiations with their employers.

In addition to Offcall's resources, there are also a host of publicly available data points and additional sources that you can use to compare where you stand.

This article will provide a few different ways to benchmark where you stand based on some of the resources that are available.

1. Check to See If You Are Paid Below the National Average in Your Metro Area

Start by comparing your salary to national averages. In addition to the Offcall Salary Tool, resources like the Medscape Physician Compensation Report and other annual surveys provide comprehensive data on physician salaries across specialties and regions.

For reference, between 2022 and 2023, the average compensation for U.S. physicians jumped nearly 6% according to the Physicians Thrive Compensation Report 2024. This rebound follows a slight decline of 2.4% in the previous year. Across different metro areas, however, there are stark differences.

Metro Areas with Highest Paid Physicians

Physicians in the San Jose area saw a significant pay boost, with an annual growth rate of 13.5%. This pushed San Jose to the top spot in average physician compensation in 2023. Here are the top 10 metro areas for average physician pay:

• San Jose, CA: $474,977
• Los Angeles, CA: $448,121
• St. Louis, MO: $442,576
• Sacramento, CA: $440,004
• Minneapolis, MN: $438,756
• San Francisco, CA: $437,628
• Phoenix, AZ: $436,837
• San Diego, CA: $430,187
• Charlotte, NC: $429,566
• Las Vegas, NV: $426,727

Metro Areas with the Lowest Paid Physicians

On the other end of the spectrum, the metro areas with the lowest average physician compensation are significantly lower. However, it is also worth noting that even these cities experienced average pay growth in 2023, with some cities like Baltimore, Providence, and Virginia Beach seeing growth rates of over 10%. Here are the lowest-paying metro areas:

1. San Antonio, TX: $371,073

2. Denver, CO: $371,215

3. Washington, DC: $371,495

4. Boston, MA: $378,273

5. Nashville, TN: $380,533

6. Baltimore, MD: $382,837

7. Philadelphia, PA: $387,254

8. Providence, RI: $390,096

9. Virginia Beach, VA: $390,604

10. Birmingham, AL: $391,290

2. Next, Check to See If You Get Paid Below Average for Your Specialty

Compensation varies significantly by specialty. Neurosurgery and orthopedic surgery remain top of the list, while pediatrics and family medicine rank towards the bottom. Here's a look at the average compensation across various specialities:

Specialties with the Highest Salaries

Here's a quick look at the top earners:

1. Neurosurgery: $788,000

2. Thoracic Surgery: $707,000

3. Orthopedic Surgery: $624,000

4. Plastic Surgery: $571,000

5. Vascular Surgery: $558,000

Specialties with the Lowest Salaries

On the other end of the spectrum, here are the specialties with the lowest average pay:

1. Pediatric Endocrinology: $218,000

2. Pediatric Infectious Disease: $221,000

3. Pediatrics: $243,000

3. Consider Whether You May Be Working Too Many Hours for Your Pay

Consider the number of hours you work and your overall workload. If you are working significantly more hours than your peers but earning the same or less, you might be underpaid. Higher workloads should typically correlate with higher compensation.

This data is typically and notoriously hard to come by. Sign up for Offcall's Salary Tool which allows you to benchmark not just overall salary, but hours worked, as a way to collect this information and put it in physicians' hands.

Another consideration here is the gender pay gap in medicine. According to the Doximity Physician Compensation Report, the gender pay gap is still prominent. On average, women physicians make $102,000 less than men, regardless of working equal hours with similar experience in the same specialties.

Additionally, African American physicians make $40,000 less on average than Caucasian and Asian American counterparts.

4. Benchmark Your Bonus and Benefits Relative to Your Peers

Physician compensation isn't limited to salary. Consider additional forms of compensation, such as signing bonuses, incentive bonuses, benefits, and retirement contributions. These can significantly impact your overall earnings.

Offcall's Salary Tool also allows you to benchmark where you stand relative to your peers across these metrics.

Consider that in 2023, 57% of specialists reported earning an incentive bonus. In addition, 53% of Primary Care Physicians earned a bonus. Here is a list of bonus averages by specialty, according to the Physicians Thrive Compensation Report:

1. Orthopedics/Orthopedic Surgery: $134,000 (up from $126,000 last year)

2. Cardiology: $88,000 (up from $85,000 last year)

3. Radiology: $80,000 (up from $66,000 last year)

4. General Surgery: $75,000 (up from $46,000 last year)

5. Anesthesiology: $68,000 (same as last year)

6. OB/GYN: $57,000 (up from $49,000 last year)

7. Emergency Medicine: $37,000 (down from $54,000 last year)

8. Psychiatry: $37,000 (up from $35,000 last year)

9. Family Medicine: $34,000 (up from $30,000 last year)

10. Internal Medicine: $33,000 (up from $29,000 last year)

11. Pediatrics: $31,000 (up from $28,000 last year)

5. Check If You Are Being Compensated for Your Experience and Education

Your level of experience and education can affect your salary. Physicians with more years of experience or additional certifications may earn more. Compare your qualifications with those of your peers to ensure you're being fairly compensated for your expertise.

One way to do this is by signing up and inputing your information confidentially as part of Offcall's Salary Tool.

6. Consider Whether You Are Satisfied with Your Career Progression

If your compensation feels inadequate compared to your job satisfaction and opportunities for advancement, it might be time to renegotiate or explore other options. According to the Doximity Compensation Report, less than one-third of surveyed physicians believed they were being paid fairly after all their experience and efforts. Because of overwork and dissatisfaction with their career trajectories, 55% of physicians seek early retirement or alternate career options outside of medicine.

Join the Discussion: What to you do if you find out you’re underpaid?

How do you open up conversations around salary at work? What are the most and least helpful ways to encourage transparency around pay and advocate for improvements?

Join the discussion and let your peers know any strategies for how you have handled salary negotiations successfully in the comments.